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European Radiology
Published in: European Radiology 9/2022

31-03-2022 | Magnetic Resonance Imaging | Breast

Can DWI provide additional value to Kaiser score in evaluation of breast lesions

Authors: Yongyu An, Guoqun Mao, Weiqun Ao, Fan Mao, Hongxia Zhang, Yougen Cheng, Guangzhao Yang

Published in: European Radiology | Issue 9/2022

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Abstract

Objectives

To explore added value of diffusion-weighted imaging (DWI) as an adjunct to Kaiser score (KS) for differentiation of benign from malignant lesions on breast magnetic resonance imaging (MRI).

Methods

Two hundred forty-six patients with 273 lesions (155 malignancies) were included in this retrospective study from January 2015 to December 2019. All lesions were proved by pathology. Two radiologists blind to pathological results evaluated lesions according to KS. Lesions with score > 4 were considered malignant. Four thresholds of ADC values −1.3 × 10−3mm2/s, 1.4 × 10−3mm2/s, 1.53 × 10−3mm2/s, and 1.6 × 10−3mm2/s were used to distinguish benign from malignant lesions. For combined diagnosis, a lesion with KS > 4 and ADC values below the preset cutoffs was considered as malignant; otherwise, it was benign. Sensitivity, specificity, and area under the curve (AUC) were compared between KS, DWI, and combined diagnosis.

Results

The AUC of KS was significantly higher than that of DWI alone (0.941 vs 0.901, p = 0.04). The sensitivity of KS (96.8%) and DWI (97.4 – 99.4%) was comparable (p > 0.05) while the specificity of KS (83.9%) was significantly higher than that of DWI (19.5–56.8%) (p < 0.05). Adding DWI as an adjunct to KS resulted in a 0–2.5% increase of specificity and a 0.1–1.3% decrease of sensitivity; however, the difference did not reach statistical significance (p > 0.05).

Conclusion

KS showed higher diagnostic performance than DWI alone for discrimination of breast benign and malignant lesions. DWI showed no additional value to KS for characterizing breast lesions.

Key Points

• KS showed higher diagnostic performance than DWI alone for differentiation of benign from breast malignant lesions.
• DWI alone showed a high sensitivity but a low specificity for characterizing breast lesions.
• Diagnostic performance did not improve using DWI as an adjunct to KS.
Appendix
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Metadata
Title
Can DWI provide additional value to Kaiser score in evaluation of breast lesions
Authors
Yongyu An
Guoqun Mao
Weiqun Ao
Fan Mao
Hongxia Zhang
Yougen Cheng
Guangzhao Yang
Publication date
31-03-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08674-x

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